[Leukinferon in the treatment of patients with acute viral hepatitis b]. / Primenenie leikinferona v lechenii bolnykh ostrym virusnym gepatitom B.

Leukinferon activity was studied in a controlled trial including 30 patients with acute viral hepatitis. The disease ran a moderate severity course in the majority of the patients. Leukinferon, a combined preparation of natural interferon and cytokines produced by virus-induced leukocytes, has marked immunomodulating properties at moderate antiviral activity. Leukinferon was administered intramuscularly for 10 days according to the following scheme: day 1-1 sample 3 times, day 2-1 ampule 2 times, day 3-10-1 ampule a day (overall 1 x 10(5) U of interferon). Due to leukinferon the symptoms of intoxication declined, hepatic biochemistry normalized more rapidly as well as the period of viremia and antigenemia. Positive clinical trends correlated with interferon system improvement and activation of natural killers. 6 months later complete recovery was registered in all leukinferon-treated subjects.

[Role of delta infection in fulminant course of viral hepatitis]. / Rol' del'ta-infektsii pri ful'minantnom techenii virusnogo gepatita.

Sera from 35 fulminant hepatitis patients admitted to the hospital at the USSR AMS Research Institute of Virology in 1985-1989 were studied for specific markers of NB and delta infection. Delta-infection as etiological factor of the disease proved in 26 patients (74.3%). Acute hepatitis of mixed etiology (HBV and HDV) occurred in 17, acute hepatitis delta in 9 patients carrying chronically HBsAg. Acute hepatitis B was verified in the rest 9 patients. Clinical, biochemical and serological aspects typical for the variety of etiological variants of hepatitis running a fulminant course are considered.

[Patterns in perinatal infection with the hepatitis B virus in areas contrasted by the level of HBsAg and HBeAg carriage]. / Zakonomernosti perinatal'nogo infitsirovaniia virusom gepatita B na territoriiakh, kontrastnykh po urovniu nositel'stva HBsAg i HBeAg.

In 1984-1988, the levels of HBsAg carrier state and the status of the "e"-system components in pregnant women in Moscow and in the Uzbek SSR, as well as the rate of infection with hepatitis B virus (HBV) in babies born to women carriers of HBsAg in regions with different levels of HBsAg and HBeAg carrier state were studied. The levels of HBsAg carrier state among pregnant women were different in Moscow and Uzbekistan (1.1% and 6.9%, respectively). It was noted that in female HBsAg carriers in these regions the rate of HBeAg detection differed greatly: 5.2% in Moscow and 13.9% in Uzbekistan. The frequency of perinatal infection with HBV in Moscow was 26.1%, in Uzbekistan 40.0%, the frequency of persistent carrier state of HBsAg in the infected babies of Uzbekistan was 16.0%. The possibility of formation of HBsAg persistence in babies born to women with HBsAg and anti-HBe in the blood was demonstrated. The problem of the use of specific prophylaxis measures to prevent perinatal transmission of HBV is discussed.

[Reaferon treatment in acute HBsAG-positive viral hepatitis]. / Lechenie reaferonom ostrogo HBsAg-polozhitel'nogo virusnogo gepatita.

Clinical, biochemical and serological examinations of 412 patients with acute HBsAg-positive virus hepatitis were conducted to assess therapeutic efficacy of Soviet recombinant alpha 2-interferon (reaferon). There were 309 cases of acute virus hepatitis B, 103 of delta infection (71--coinfection, 32--superinfection). The study and control groups were assigned randomly. Reaferon i.m. administration started on jaundice day 1-5 and lasted for 10-11 days. The treatment proved effective in acute hepatitis B running a moderately severe and severe course up to the development of acute hepatic encephalopathy. In delta infection reaferon produced response in coinfection only. In fulminant hepatitis the treatment was uneffective.

[Perinatal infection with hepatitis B virus and the problem of its specific prevention]. / Perinatal'noe infitsirovanie detei virusom gepatita B i voprosy spetsificheskoi profilaktiki.

The incidence of HBs- and HBe-antigens detection in future mothers was studied in Moscow, Uzbekistan, and Moldavia, and the incidence of hepatitis B (HB) virus transmission from mothers with persisting HBs-antigenemia to their offspring. In reverse passive hemagglutination test, HBsAg was detected in 1.1% of pregnancies in Moscow, in 6.3% of pregnancies in Uzbekistan, and in 5.4% of pregnancies in Moldavia. In these regions, immunofluorescence revealed HBe-antigen in HBsAg carriers in 5.2, 13.9, and 16.3%, respectively. Perinatal infection with HB virus was found in 26.1% of births to HBsAg carriers in Moscow and in 40% in Uzbekistan and Moldavia; in the latter two regions 16.0% and 13.3% of these births were found to become chronic carriers of HBsAg. In the presence of persistence of HBeAg in HSsAg carriers, from 89 to 100% births to these mothers showed the development of durable HBs-antigenemia, while in the presence of anti-HBe such outcome was noted in only 3%. Specific anti-HBs-immunoglobulin administered to infants born to HBsAg carriers exerted a protective effect by reducing the HB virus infection rate in the first 6 months of life, but failed to prevent completely the development of HB virus infection. The necessity of a wide-scale vaccination against HB in order to prevent HB virus infection of neonates is emphasized.

[Viral hepatitis in pregnant women--the relationship of the severity of the disease to the etiology of the infection]. / Virusnye gepatity u beremennykh--zavisimost' tiazhesti bolezni ot étiologii infektsii.

The author summarizes the experience of many years (1956-1989) gained with studies into the relationship between the gravity of viral hepatitides in the pregnant and etiology of disease. Virus A hepatitis runs a favourable course in the pregnant, i.e. without severe and fulminant forms. In virus B hepatitis, the pregnant women are threatened with the development of hepatic coma associated with a high maternal lethality. The latter one has noticeably been decreasing over the recent years (from 1.79% in 1956-1965 to 0.29% in 1966-1980 and to 0.21% in 1981-1989, which is not so much related to the perfection of the treatment methods as to the diminution of the share of virus B hepatitis. Virus E hepatitis may be of the greatest mortal danger for mothers in conditions of water epidemic. In that case the lethality among pregnant women may reach 12.1% (in the Turkmenian SSR) and 15.6% (in the Kirghiz SSR). The aggravating influences of virus C and D hepatitides on the pregnancy outcomes and maternal lethality have not been studied much. Estimation of etiological factors in viral hepatitis occurring in the pregnant is an important prerequisite for organization of the rational preventive and treatment measures.

[A study of the effect of thymotropin on immunologic indicators and excretion of virus in women with chronic cytomegalovirus infection]. / Izuchenie vliianiia timotropina na immunologicheskie pokazateli i ékskretsiiu virusa u zhenshchin s khronicheskoi tsitomegalovirusnoi infektsiei.

Thymotropic hormone was given subcutaneously in a dose of 100 mg twice a week for 3 months to 10 women with verified chronic cytomegalovirus infection. After termination of the treatment, in 8 women the virus excretion was decreased and this was accompanied with some improvement in immunological parameters: increased activity of natural killers, enhanced interferon-producing activity of lymphocytes, higher theophylline-resistant lymphocytes, and lower theophylline-sensitive T-cells. The above results confirm the association between the activity of cytomegalovirus infection and the state of immunity and allow thymotropic hormone to be recommended for treatment of other groups of patients with cytomegalovirus infection.

[Cytomegalovirus infection in clinical medicine]. / Tsitomegalovirusnaia infektsiia v klinicheskoi meditsine.

The author provides the data on studies into cytomegaloviral infection for many years, the results of examinations made during prospective clinico-virological and immunological follow up of 236 women with an unfavourable obstetrical disease history and verified cytomegaloviral infection. The diagnosis, epidemiology and the spectrum of the clinico-pathogenetic patterns of the infection are under discussion. The use of the immunocorrective drugs (levamisole, T activin) for the treatment of the private patterns of cytomegaloviral infection provided beneficial results. The prospects of further study into the problem are analyzed.

[Interferon in the treatment of acute viral hepatitis B]. / Interferon pri lechenii ostrogo virusnogo gepatita B.

The Soviet leukocytic alpha 2-interferon obtained by gene engineering was assessed (according to the clinical and biochemical findings) for the therapeutic efficacy in acute viral hepatitis B. The drug was injected intramuscularly to patients with grave and medium-grave hepatitis during 10 days. The treatment was instituted within the first 1-5 days of jaundice. The patients with medium-grave acute viral hepatitis B manifested a beneficial therapeutic effect of alpha 2-interferon obtained by gene engineering as did the patients with the grave disease pattern before they developed the signs of liver encephalopathy.

[Action of acyclovir on cytomegalovirus in tissue culture and in chronic infection in women]. / Deistvie atsiklovira na tsitomegalovirus v kul'ture tkani i pri khronicheskoi infektsii u zhenshchin.

Acyclovir was capable to delay for some time the development of the cytopathic effect in cell cultures. When acyclovir was added to the infected tube cultures in a concentration of 250 micrograms/ml, virus reproduction was inhibited for 6 days. Then foci of lesions were observed, and by the 12-13th days the intensity of involvement of the cell layer was 80-90% and did not differ from that in control tubes infected with cytomegalovirus (CMV). No significant differences were observed in the inhibiting effect of acyclovir on the freshly isolated strains or the reference Ad-169 strain. A course of therapy with acyclovir showed the inhibiting effect of this drug on CMV reproduction in women with the CMV infection to be of short duration. The temporary improvement observed on the first day after treatment was accompanied by reduced virus excretion with both the urine and saliva. Antibody titres remained the same before and after treatment. After 1-2 months virus excretion was observed practically in all the women similarly to that before the treatment.

[Characteristics of the transmission of hepatitis B virus infection to infants from their mothers--chronic HBsAg carriers with anti-HBe present]. / Osobennosti peredachi HB-virusnoi infektsii detiam ot materei--khronicheskikh nositelei HBsAg pri nalichii u nikh anti-HBe.

A series of long-term prospective studies was carried out to investigate the possibilities and manifestations of perinatal infection in Moscow. The observations included 45 mothers, chronic carriers of HBsAg, and their 48 babies. In most of the mothers (31 out of 41), HBs antigenemia was accompanied by the presence of anti-HBe. No persisting HBsAg carrier state was ever detected in the newborns, although in 9 out of 48 babies transitory ephemeral infection was recorded with minimal clinico-biochemical disorders in 6 and complete lack of any such disorders in 3. The above results are compared with the observations in the countries of South-East Asia, West Africa, Europe and the USA. The causes of significant differences in the epidemiological role of perinatal infection in different world regions are discussed. The primary role of anti-HBe formation, ecological, and genetic factors is emphasized.

[Markers of hepatitis B virus infection in infants born of mothers who are HBs-antigen carriers with anti-HBe present and the problems of passive immunoprophylaxis]. / Markery HB-virusnoi infektsii u detei, rodivshikhsia u materei-nositelei HBs-antigena s nalichiem anti-HBe, i voprosy passivnoi immunoprofilaktiki.

In December, 1983 to December, 1985, blood sera of 14,603 pregnant women were tested for the detection of HBsAg carriers among them. A low level (1.1%) of HBsAg carrier state was demonstrated. HBeAg was detected in 5.2% of women-carriers of HBsAg, anti-HBe in 68.8%. The follow-up observations involved 59 babies born to the mothers HBsAg-carriers. The babies were divided into an experimental and a control group. The experimental group consisted of 22 babies who were given specific anti-HBs immunoglobulin, 37 babies of the control group did not receive this preparation. In the experimental group, 3 babies were found to be infected, all of them at the age of 9-12 months. In the control group the infection was detected in 9 babies, among them in 5 the markers of hepatitis B virus were detected at the age of 1-2 months. Based on these data, the efficacy of using anti-HBs immunoglobulin for prevention of neonatal hepatitis B is discussed.